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Louisiana rates for HCPCS 0017M

Oncology (diffuse large B-cell lymphoma [DLBCL]), mRNA, gene expression profiling by fluorescent probe hybridization of 20 genes, formalin-fixed paraffin-embedded tissue, algorithm reported as cell of origin

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,660.82 / $3,622.23 / $13,203.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,506.13 / $2,987.15 / $3,263.27
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,718.06 / $4,902.18 / $7,724.42
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$547.09 / $597.91 / $663.68
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,510.21 / $2,510.21 / $2,510.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,631.64 / $2,021.60 / $19,059.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,054.29 / $1,506.13 / $3,419.42